Dispatch From Haiti: Trump and Breastfeeding

by JOHN CARROLL MD

Mother with Infant in Cite Soleil. Photo by John Carroll.

When the late Dr. Paul Blough retired from his private OB-Gyn practice in Peoria, Illinois in the mid-80s, he moved to Haiti. And over the next couple of decades “Dr. Paul” delivered over 10,000 babies in Cite Soleil. I remember his eyes moistening in the delivery room of St. Catherine Laboure Hospital, when he told me that the day he delivered a baby would be the healthiest day of the baby’s life. He knew the health risks the babies faced in Cite Soleil when they were discharged from the hospital the following day.

During the last 15 years, I have examined many infants in a pediatric clinic in Cite Soleil. Skin diseases, respiratory tract infections, and diarrhea are common in the slum. But it is very difficult for me to get my mind around the concept of starving babies in 2018.

Many of the malnourished babies are carried to clinic by very young mothers, working mothers, older siblings, grandmothers, the next door neighbor lady, or the baby’s fathers. Frequently, the worst ones are not breastfeeding and are only taking formula. And what happens if the formula is diluted to make it last longer? (Infant formula is expensive.) What happens if dirty water is mixed with the formula? Babies get sick, shrivel up, and die.

Why would Haitian babies in the slum not breastfeed? Maybe the mother is not home much of the day because she is sewing Hanes t-shirts in a factory on Airport Road in Port-au-Prince. Maybe the mother went crazy and left the slum. Maybe the mother died during the baby’s delivery. (Haiti has one of the highest maternal mortality rates in the world.) Maybe the mother has been sick and does not think she should breastfeed the baby. Maybe the mother just thinks her breast milk is bad. Maybe the mother has no milk because the baby has been using formula. I have heard all of these reasons.

And what happens if the mother actually thinks formula bought on the street corner is better than natural breastfeeding? I remember decades ago hearing the story of baby formula advertisements from the United States influencing Haitian women that formula feeding was the right choice for their infants.

From RS Athion’s  piece in CounterPunch  “The Sordid History of Infant Formula and Trump’s Attempt To Bully, Blackmail & Threaten Third World Countries”

“The 1974 article titled The Baby Killer blew the lid off the Nestle bottle formula scandal. Companies like Nestle used women in nurses uniforms to sell their baby formula (to women in the “third world.”) They provided free samples to mothers who would use the formula. These women would then find their breasts had stopped giving milk after a month of using the infant formula. Now they were hooked and needed to pay for the formula, yet the family income in many cases was only $7 a week. What unfolded was a tragedy: from mixing the baby water with unsafe water sources to not being able to afford the expensive baby formula and diluting it to make it last longer. The result was deaths of babies in the millions, malnourished babies with stunted growth condemned to a lifetime of physical and mental disability.

“A stunning example of free-market murder feeding the world’s children to an $11.5 billion industry. A million infant deaths a year are blamed on reliance on infant formula rather than breastfeeding.”  (Parentheses mine.)

Four decades later, science still supports the benefits of breast milk.

In 2016, the medical journal Lancet had a series on breastfeeding–

“Breastmilk makes the world healthier, smarter, and more equal: these are the conclusions on breastfeeding. The deaths of 823,000 children and 20 000 mothers each year could be averted through universal breastfeeding, along with economic savings of US $300 billion. The Series confirms the benefits of breastfeeding in fewer infections, increased intelligence, probable protection against overweight and diabetes, and cancer prevention for mothers.

“Breastfeeding for all infants is strongly supported by both governmental and medical professional organizations because of its acknowledged direct benefits to the infant’s nutrition, gastrointestinal function, host defense, and psychological well-being.

“Human milk compared with formula may provide continued protection against acute illnesses even after discontinuation of breastfeeding during the first few years of life.

“Breastfeeding decreases out-of-pocket expenditures because it reduces the expense of buying formula. In addition, because of the decreased risk of illness in breastfed infants, there is a reduction in out-of-pocket expenditures on copayments for outpatient visits, hospitalizations, and medications, and a decrease in parental work absences.”

(Obviously, co-payments and the worry about parenteral work absences don’t affect most Haitian slum women.)

So how is Donald Trump involved with breastfeeding? Well, an amazing event just happened several days ago. The New York Times, July 8, 2018, reported the following regarding a recent United Nations Health Assembly:

“A resolution to encourage breastfeeding was expected to be approved quickly and easily by the hundreds of government delegates who gathered this spring in Geneva for the United Nations-affiliated World Health Assembly.

“Based on decades of research, the resolution says that mother’s milk is healthiest for children and countries should strive to limit the inaccurate or misleading marketing of breast milk substitutes.

“Then the United States delegation, embracing the interests of infant formula manufacturers, upended the deliberations.

“American officials sought to water down the resolution by removing language that called on governments to “protect, promote and support breastfeeding” and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children.

“When that failed, they turned to threats, according to diplomats and government officials who took part in the discussions. Ecuador, which had planned to introduce the measure, was the first to find itself in the cross- hairs.

“The Americans were blunt: If Ecuador refused to drop the resolution, Washington would unleash punishing trade measures and withdraw crucial military aid. The Ecuadorean government quickly acquiesced.

“In the end, the Americans’ efforts were mostly unsuccessful. It was the Russians who ultimately stepped in to introduce the measure — and the Americans did not threaten them.”

After the Times story, Donald tweeted the following:

“The failing NY Times Fake News story today about breastfeeding must be called out. The U.S. strongly supports breastfeeding but we don’t believe women should be denied access to formula. Many women need this option because of malnutrition and poverty.”

However, I would disagree and say POOR women need to breastfeed, because it leads to LESS malnutrition and starvation and better health for their children and for them. (I am intentionally leaving HIV out of this discussion.)

I think Donald was supporting the 70 billion dollar infant formula business and thank God for Russia and their timely intervention. Maximum profit is the driver. The well-being of poor babies around the world doesn’t seem to count to the leader of the free world.

“Dr. Paul” from Peoria would have a hard time believing all of this.

John A. Carroll, M.D. is a physician working in Port-au-Prince.

https://www.counterpunch.org/2018/07/13/dispatch-from-haiti-trump-and-breastfeeding/